The Clinical Value of Peep Chosen by Graded Approach on Disease Mortality of ARDS Patients

Objective:To study the clinical value of PEEP chosen by graded approach on mortality of ARDS patients. Methods: 88 ARDS patients received mechanical ventilation with PEEP chosen by two means. The PEEPs of 51 among them were chosen by graded approach,if the grade was bigger than or equal to 6,PEEP(20-25cmH2O) was chosen;if the grade was between 3 to 5, PEEP(12-20cmH2O) was chosen;if the grade was smaller than or equal to 2, PEEP(5-12cmH2O) was chosen. The PEEPs of another 37 patients were chosen by traditional means with PEEP(5-12cmH2O). The arterial blood gases indexes were detected at the start of mechanical ventilation,24 hours after the start. The mortalities of two groups were calculated, the complication were observed from day 1 to day 30 in ICU. Results: The disease mortality of grade group decrease much than traditional means group(P0.01); The disease mortality of low PEEP(5-12cmH2O) group of grade group decrease much than traditional means group(P0.05). Arterial blood oxygenations were obviously improved in two groups after 24 hours mechanical ventilation,grade group had better partial pressure of oxygen in artery(PaO2) than traditional means group (P0.001). All patients showed no ventilator-induced lung injury. The occurring rate of MOF of grade group was lower than traditional means group(P0.05). The occurring rate of arterial blood pressure drop(10mmHg) was higher than traditional means group(P0.05) ,but this arterial blood pressure drop could be cured. Conclusion:The clinical value of PEEP chosen by graded approach is higher than traditional means. There are lower disease mortality, better arterial blood oxygenations,fewer complication with PEEP chosen by graded approach than traditional means or the complication can be cured.